At 12, Moreno learned after gallbladder surgery that her body was working toward Type 2 diabetes. She began injecting insulin into her arm when she was 16.

The onslaught of health issues hit during her last pregnancy in 2010. Much of the 70 pounds she packed on was excess fluid caused by severe edema, a process that occurs when leaky, small blood vessels release fluid into body tissues and cause swelling.

Moreno survived a heart attack three years ago - another complication of diabetes.

Medication controls the chest pains that have plagued her since. She takes 22 pills per day to deal with high blood pressure, high cholesterol, heart disease, kidney failure and onset of blindness.

She stores her medications in an oversized cosmetic bag because they have outgrown her pill organizer.

Her prescriptions cost $2,000 per month, of which Medicare parts A and B pay 80 percent. She plans to apply for Medicare part D in November. Her inability to cover the monthly fee left her without that coverage last year.

"I don't want to go to dialysis or the doctor," Moreno said. "I owe so much money, and I don't have payments."

With only 5 percent kidney function in 2011, she began peritoneal dialysis, a home treatment that uses the lining of the abdominal cavity and a solution to remove wastes and extra fluid from the body.

A tube inserted into her stomach filtered her kidneys from 8 p.m. to 6 a.m. while she slept. Multiple infections at two entry sites landed her in Warm Springs for four weeks. After her release, she started hemodialysis, which uses a man-made membrane to filter wastes and remove extra fluid from the blood.

Three days per week, Moreno goes to Liberty Dialysis in Victoria, where technicians plug her into a machine from 6:30 a.m. to 11:30 a.m. She sleeps during the sessions unless her legs cramp. When she screams, technicians administer saline, which helps.

Hemodialysis wiped her out at first. She felt sick and depressed all the time and dropped 30 pounds.

"Now, I look at dialysis as a second chance," she said. "I'm lucky, at least I haven't been told I'm going to die next week or next month."

Persons who are overweight or obese are at higher risk of developing diabetes, Chand said. Other factors include a diet high in carbohydrates, a sedentary lifestyle and a family history of the disease.

"Developing complications depends on how well you manage the risk factors," he said. "Seeing a doctor can delay other complications."

Stress, which can cause people to overeat and indulge in too much alcohol, plays a huge role in the development of diabetes, said Dottie Bitterly, registered nurse and certified diabetes educator.

"We should be eating healthiest, exercising and practicing meditation during our most stressful times," Bitterly said.

Moreno needs a new kidney, but few in her family are donor candidates because they are either too sick, too young or too old to qualify. One cousin has agreed to the testing to determine whether her kidney is a good match for Moreno.

"People die waiting because there are so many people on the list," Moreno said.

Moreno feels like a ticking time bomb.

Her family fears for her life. When she does not answer the phone, her mother worries. Last year, her son told his school counselor that he feared his mother might die. Moreno's husband of eight years begs her not to die because he needs her.

At one point, Moreno even offered her husband the opportunity to leave.

"I asked him for a separation because I thought he was too young to deal with all of this," she said. "He's a wonderful man who has stuck by my side."

Despite coming from generations of women who have cooked with large quantities of lard, Moreno is breaking the cycle. She prepares tilapia and chicken instead of red meat, and her children drink water or sugar-free Kool-Aid instead of sodas.

"Hispanics are more likely to develop diabetes, but there are no barriers to the disease - it goes after everyone," Bitterly said. "We need to stand up and fight and not be complacent."